Can heart palpitations, dizziness and fainting be a sign of a serious, underlying heart condition?

It seems there really is no short and simple answer to this question. According to Dr Israel (Pro) Obel, a cardiologist involved in cardiac electrophysiology and arrhythmia management at Netcare Milpark Hospital, when it comes to palpitations and dizzy spells it largely depends on their severity, regularity and what accompanies the palpitations.

“The personal medical history of the patient also has to be considered as serious rhythm disturbances are more likely if you have experienced cardiac problems in the past. A family history of fainting, or sudden unexplained death, particularly at a young age, can also not be disregarded,” explains Dr Obel.

His greatest concern is the fact that patients generally seek neurological advice in the event of dizziness and fainting spells instead of looking to their heart health. “The diagnosis most often made in this instance, usually erroneously because it is a very difficult disease to diagnose, is that of epilepsy. Instead of opting for a costly MRI scan I strongly suggest that patients experiencing dizziness, fainting, shortness of breath, chest discomfort or pain have their cardiac health checked first and foremost.”

All is not gloom and doom - according to Dr Obel it is unusual that the occasional skipping of a heartbeat, flutter or pounding heart will indicate a serious problem - especially in younger, healthy individuals with no cardiac history. Even though heart palpitations can be a matter of concern they can also prove to be quite harmless. Palpitations can be caused by anything from anxiety to stress, excess caffeine or alcohol, fever, hormone changes and certain medication such as pseudoephedrine, an ingredient found in some cold and allergy medication.

“If heart palpitations are accompanied by dizziness, shortness of breath, chest discomfort or pain and fainting, it is imperative to see a doctor who may recommend further evaluation as well as heart monitoring tests,” suggests Dr Obel.

There are many cardiovascular diseases that have heart palpitations, dizziness, shortness of breath, chest discomfort or pain and even fainting as its symptoms. Amongst these are arrhythmias, heart valve disease, cardio-myopathy, angina and even heart attacks.

“All are serious diseases that could cost you your life,” says Dr Obel. “It is therefore imperative that you do not ignore any combination of these symptoms. It is better to rather be overly worried than assuming that you have nothing to be worried about. But when you find yourself fainting for seemingly no reason, don't just assume that it is a neurological problem. Chances are that it may have more to do with your heart.”

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